Ursodeoxycholic acid combined with percutaneous transhepatic balloon dilation for management of gallstones after elimination of common bile duct stones

• Published in: World journal of gastroenterology : WJG Vol. 24; no. 39; pp. 4489 - 4498
• Main Authors: Chang, Hai-Yang, Wang, Chang-Jun, Liu, Bin, Wang, Yong-Zheng, Wang, Wu-Jie, Wang, Wei, Li, Dong, Li, Yu-Liang
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 21.10.2018
• Subjects: Aged; Aged, 80 and over; Catheterization - adverse effects; Catheterization - instrumentation; Catheterization - methods; Cholagogues and Choleretics - therapeutic use; Cholangiography; Choledocholithiasis - diagnostic imaging; Choledocholithiasis - diet therapy; Choledocholithiasis - therapy; Combined Modality Therapy - adverse effects; Combined Modality Therapy - methods; Common Bile Duct - diagnostic imaging; Diet, High-Fat; Dilatation - adverse effects; Dilatation - instrumentation; Dilatation - methods; Endoscopy, Digestive System; Feasibility Studies; Female; Gallbladder - diagnostic imaging; Gallstones - diagnostic imaging; Gallstones - diet therapy; Gallstones - therapy; Humans; Male; Middle Aged; Retrospective Studies; Retrospective Study; Treatment Outcome; Ursodeoxycholic Acid - adverse effects; Ursodeoxycholic Acid - therapeutic use; Common bile duct stones; Gallstones; Percutaneous transhepatic removal; Ursodeoxycholic acid
• ISSN: 1007-9327; 2219-2840; 2219-2840
• DOI: 10.3748/wjg.v24.i39.4489

To evaluate the effectiveness and safety of combined ursodeoxycholic acid and percutaneous transhepatic balloon dilation for management of gallstones after expulsion of common bile duct (CBD) stones. From April 2014 to May 2016, 15 consecutive patients (6 men and 9 women) aged 45-86 (mean, 69.07 ± 9.91) years suffering from CBD stones associated with gallstones were evaluated. Good gallbladder contraction function was confirmed by type B ultrasonography. Dilation of the CBD and cystic duct was detected. Percutaneous transhepatic balloon dilation of the papilla was performed, ursodeoxycholic acid was administered, and all patients had a high-fat diet. All subjects underwent repeated cholangiography, and percutaneous transhepatic removal was carried out in patients with secondary CBD stones originating from the gallbladder. All patients underwent percutaneous transhepatic balloon dilation with a primary success rate of 100%. The combined therapy was successful in 86.7% of patients with concomitant CBD stones and gallstones. No remaining stones were detected in the gallbladder. Transient adverse events include abdominal pain ( = 1), abdominal distension ( = 1), and fever ( = 1). Complications were treated successfully nonsurgical management without long-term complications. No procedure-related mortality occurred. For patients with concomitant CBD stones and gallstones, after percutaneous transhepatic removal of primary CBD stones, oral ursodeoxycholic acid and a high-fat diet followed by percutaneous transhepatic removal of secondary CBD stones appear to be a feasible and effective option for management of gallstones.